If variations of your daughter’s most extreme behavior – like spitting in your face – happen often, you should look for outside help from a therapist.

A therapist can act as a mediator. He or she will listen to the child’s point of view and the parent’s point of view, then try to find common ground – acting as a buffer on both sides. Finding the right therapist might be challenging, but the time and energy invested is worth it for solving extreme behavior challenges.

Adolescents often exhibit Jekyll and Hyde-like behavior. One minute they are calm and rational – in cool cognition. The next, they are screaming, emotional, and irrational – in hot cognition. This is caused by changes in the way neurotransmitters function in the brain during adolescence that have a huge impact on behavior. Dopamine is distributed differently in the brain during puberty, and that can result in mood changes, difficulty with emotional control, and increased risk taking. Adolescents also experience decreases in serotonin, a second neurotransmitter, which results in decreased impulse control. All of that mixes together to create a quickness to anger; intense, sudden mood swings; and poor decision making based on gut feelings.

Teens rely disproportionately on their emotional brain, and have increased hot cognition versus cold cognition. More often than not, they are trying to think under conditions of high arousal and intense emotions. It’s hard to do your best thinking in those circumstances.

If you’re handling extreme mood changes without the help of a therapist, remember not to intervene in the heat of the moment. Come up with a game plan for how you will handle outbursts and set some rules. Let your teen know in advance, “When you swear at me, here’s what I am going to do.”

Use your example as a way to help your teen understand how people might react to her behavior. Have a conversation with your teen and say, “When you do this, this is how I react, and it doesn’t make me feel good. I must do some things that don’t make you feel good. Let’s see if we can put those on the table, and come up with a way to handle our problems that doesn’t involve either of us doing those things that make us both feel bad.”

Engage in a collaborative relationship that isn’t just top-down, hierarchical, “You’re going to do this because I tell you to do this.” Approach the conversation as, “Let’s put our heads together. This is what it looks like from my perspective. You tell me what it looks like from your perspective.” Teens will often rise to the occasion when treated as another adult. Ultimately, it’s up to the parents to make decisions, but leading up to the decision, involving your teen can help smooth disagreements without an explosion.

This advice came from “The Teen Brain on ADHD,” a February 2018 ADDitude webinar lead by Peg Dawson, Ed.D., that is now available for free replay here.